Dear MR.
RAJEEV AJMERA,
Greetings from Mahindra Insurance Brokers!!!
We welcome you to the Ensure by Mahindra family and thank you for choosing our Insurance Program.
Ensure by Mahindra is a specially designed Insurance Program to give you a delightful ownership experience of the Mahindra
vehicle by giving a smooth hassle free experience on your Vehicle Insurance. The Insurance is provided by the Insurance companies
with whom MIBL is associated for selling its products.
The key benefits will be as follows:
Near Cashless facility
Standard and faster Claim settlement
Hassle -free Renewal
Range of Add-on Covers
Your satisfaction is our first priority. Please find enclosed:
Certificate of Insurance (insurance policy)
Policy wordings providing Terms & Conditions
All the above benefits will be available to you at Mahindra Dealer Service Centres. In the unfortunate event of damage to your
Vehicle all you need to do is to get in touch with the Dealer Service Centre or the Insurance Company by dialling on the toll free
number 022 6234 6234
We once again thank you for choosing Ensure by Mahindra.
Best Wishes
Mahindra Insurance Brokers
HDFC ERGO General Insurance Co. Ltd.
Standalone own Damage Policy ±Private Car CUM RECEIPT UIN:IRDAN125RP0001V01201920
(FORM 51 OF THE CENTRAL MOTOR VEHICLE RULES, 1989)
Servicing Office of Insurer: HDFC ERGO General Insurance Company Limited, 6th Floor, Leela Business Park, Andheri
Kurla , Road, Andheri (E), Mumbai, Maharashtra 400059 , MUMBAI , MAHARASHTRA-400059 State Code-27
PAN: AAACT0627R GSTIN: 27AABCL5045N1Z8 Toll Free: 022 6234 6234
Policy No & Policy Issued On 2302205126973901000 , 22 Dec 2023 2:05PM Period of Own Damage Cover 05 Jan 2024 12:00AM to 04 Jan 2025 11:59PM (Midnight)
Proposal No. & Date P19939759, 22 Dec 2023 Other TP Policy No MAG10515
Insured Name MR. RAJEEV AJMERA Other TP Policy Insurer Future Generali India Insurance Co. Ltd.
Insured Contact No XXXXXX5944 Period of other TP Cover 05 Jan 2022 12:00AM to 04 Jan 2025 12:00AM (Midnight)
15 DEEPAK VILLA FLAT NO 402,VALLABH NAGAR
Previous Policy No 2302205126973900000
Insured Add. SOCIETY N S RD-4, JVPD VILE PARLE WEST,
Previous Insurer HDFC ERGO General Insurance Co. Ltd.
MUMBAI , MAHARASHTRA-400056
Make Model Variant Cubic Capacity/GVW/Kw Seating capacity
MAHINDRA & MAHINDRA XUV700 XUV700 AX7 L PET AT 7 SEATER WHT 1997 7
Vehicle Type Vehicle Sub Class Carrier Type Fuel Type Engine No. Chassis No./VIN
PRIVATE CLOSE PETROL ZFM4L37398 MA1NE2ZF8M6L16977
Manufacturing Year RTO Registration No. Registration Date CNG/LPG Kit Trailer Chassis No/VIN
2021 MUMBAI - MH02 MH 02 FR 8019 05 Jan 2022 0
Vehicle IDV Body IDV Trailer IDV Non-Elec. Accessories IDV Elec. Accessories IDV Total IDV
1615179 0 0 0 0 1615179
Schedule of Premium (Amount in Rs.)
Own Damage Premium (A)
Basic Premium Deductibles
Vehicle 8,335 Voluntary Deductibles (0) (IMT-22A) 0
Trailer (IMT - 30) 0 Anti Theft Device (IMT-10) 0
Non-Elec. Accessories 0 AA Membership (IMT-8) 0
Elec. Accessories (IMT-24) 0 No Claim Bonus (25%) 2,084
CNG/LPG Kit (IMT - 25) 0 Sub Total (Deductibles) 2,084
Sub Total (Basic Premium) 8,335 Net Own Damage Premium (A) 17,909
1612
Geographical Area Extension (IMT-1) 0 CGST(9.00%)
SGST(9.00%) 1612
IMT - 34 0
Lamp,Tyre Mudguards (IMT - 23) 0 Gross Premium Paid 21,133
Note: 1.Policy issuance is subject to realization of cheque
2.: I/ WE HEREBY CERTIFY THAT THE POLICY TO WHICH THE CERTIFICATE RELATES AS WELL
Add On (Cost of Consumable Items,Emergency AS THE CERTIFICATE OF INSURANCE ARE ISSUED IN ACCORDANCE WITH THE PROVISION OF
CHAPTER X, XI OF M. V. ACT 1988." THE STAMP DUTY OF RS 0.50 PAID BY THE DEMAND
Assistance Cover,Engine Protection,Zero Depreciation 11658 DRAFT, VIDE RECEIPT/ CHALLAN NO. LOA/CSD/547/2022/5450/22 AND DATED 22/DEC/2022 AS
Claim) PRESCRIBED IN GOVERNMENT OF MAHARASHTRA ORDER NO MUDRANK -2017/CR.97/M-1,
DATED THE 09TH JANUARY 2018".
Sub Total-Addition 19,993 3.The policy is subject to compulsory deductible of Rs.2000 (IMT-22)
4.Geographical Area-India
*Subject to IMT Endt. Nos.& Memorandum:,22,7
Hypothecation Details: Hypothecation, ICICI BANK LTD, - MUMBAI
MISP Details: Name: NBS INTERNATIONAL LTDCode: MIBL/M&M/AAACN3646E/000 Receipt No: 2051269739010 Payment Mode: ONLINE Reference code: LN010391BNB02
Addon Cover(s) : 1) , , ,
Limitations as to use: The Policy covers use of the vehicle for any purpose other than:a)Hire or Reward b)Carriage of goods (other than samples or personal luggage) c)Organized racing
d)Pace making e)Speed testing f)Reliability Trials g)Any purpose in connection with Motor Trade
Limits of Liability: (a) Under Section II-I(i) of the policy: Death of or bodily injury - Such amount as is necessary to meet the requirements of the Motor Vehicles Act,1988. (b) Under Section
II-I(ii) of the policy: Damage to Third Party Property ` 750000/-; PA Cover for Owner-Driver under Section III: CSI ` 0/-. The Compulsory Personal Accident cover has not been opted in this
policy
Driver¶s Clause: Any person including the insured: Provided that the person driving holds an effective driving license at the time of the accident and is not disqualified from holding or
obtaining such license. Provided also that the person holding an effective learner's license may also drive the vehicle & that such a person satisfies the requirements of Rule 3 of the Central
Motor Vehicle Rules, 1989.
NCB Clause: No Claim Bonus is subject to no claim on the previous policy. Benefits under the policy stands forfeited if claim is/was made in previous policy. No Claim Bonus will only be
allowed, provided the policy is renewed within 90 days of the expiry of the previous policy.
Grievance Clause: For resolution of any query or grievance, Insured may contact the respective branch office of the company or may call at 022 6234 6234 or may write an email at
care@hdfcergo.com. In case the insured is not satisfied with the response of the office, insured may contact the Grievance Officer of the Company at care@hdfcergo.com.In the event of
unsatisfactory response from the Grievance Office, he/she may, subject to vested jurisdiction, approach the Insurance Ombudsman for the redressal of grievance. Details of Insurance
Ombudsman offices are available at IRDA website:www.irdai.gov.in , or on the website of General Insurance Council: www.gicouncil.in or on the company website www.hdfcergo.com.
The Policy wording is available on request at free of cost. The Same can be downloaded from our Website www.hdfcergo.com.
Important Notice: The insured is not indemnified, if the vehicle is used or driven otherwise than in accordance with this Schedule. Any payment made by the Company by reason of wider
terms appearing in the Certificate in order to comply with the Motor Vehicle Act, 1988 is recoverable from the insured. See the clause headed ³AVOIDANCE OF CERTAIN TERMS AND
RIGHT OF RECOVERY´For legal interpretation, English version will hold good.
This policy provides only Own Damage cover to the insured vehicle and no other liability is covered under the policy
I/ We hereby declare that though our aggregate turnover in any preceding financial year from 2017-18 onwards is more than the aggregate turnover notified under sub-rule (4) of rule 48, we are
not required to prepare an invoice in terms of the provisions of the said sub-rule.
HSN : 997134 Description of Service: Motor vehicle Insurance Place of Supply : MAHARASHTRA(State Code : 27) Invoice Number : 2051269739010
UIN: IRDAN125RP0001V01201920 For & On Behalf of HDFC ERGO General Insurance Co. Ltd.
Warranty:Warranted that the insured named herein/owner of the vehicle holds a valid
Pollution Under Control (PUC) Certificate and/or valid fitness certificate, as applicable, on
the date of commencement of the Policy and undertakes to renew and maintain a valid and
effective PUC and/or fitness Certificate, as applicable, during the subsistence of the Policy.
Further, the Company reserves the right to take appropriate action in case of any
discrepancy in the PUC or fitness certificate.
Authorized Signatory
Broker Name & Corporate Add: Mahindra Insurance Brokers Limited , Ground Floor, Sadhana House, Behind Mahindra Towers, 570 P.B.Marg, Worli, Mumbai-400018
Email id: insurance.care@mahindra.com Toll Free No: 1800 266 2626 , Mon to Sat from 10.00 AM
License Code No: 261 & Validity: 17-05-2025 CIN:U65990MH1987PLC042609
